This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Specific Aims and Results The Primary Specific Aims of this Pilot Project are the following: 1. Determine whether HIV-related perceived stigma is a factor contributing to a delay in the diagnosis for Puerto Rican patients living with HIV/AIDS. 2. Define whether the presence of depression is associated with a delay in diagnosis in patients with HIV/AIDS. Introduction and Significance An important number of HIV/AIDS patients present to our health care facilities with advanced HIV infection. Over 25% of our HIV infected patients initially seen in our health care facilities present with a CD4 cell count under 200/ul, in addition many of these patients have as their initial HIV presentation the presence of an opportunistic infection. In effort to understand some of the factors which may be contributing to a delay in the diagnosis of HIV infection we have initiated this pilot study. We have performed a case control study in which patients with an early presentation of HIV infection (those with a CD4 cell count greater than 200/ul were compared with those with a late presentation (those with a CD4 cell count under 200ul/ml). At study entry a general instrument which explores the spectrum socio-demographic, risk behaviour, lifestyle, psychosocial variables as well as clinical, immunological and virological data were obtained in all patients. For this study we also applied an instrument for the evaluation of perceived stigma which had been validated at one of the centers of the CCHD as well as the Beck Depression inventory. The assessment of these additional factors would allow an additional evaluation, which may contribute to our understanding of HIV patients who are diagnosed late in their disease. This is the first study that will investigate these relationships in Puerto Rico.